Abstract
Hepatitis B (HBV) and C (HCV) are two among the numerous forms of infections whose clinical degeneration, morbidity–mortality and low immune responsiveness in people living with human immunodeficiency virus (HIV) are highly evident. Co-infection of HIV with HBV and HCV has been associated with reduced survival, increased risk of progression to liver diseases and increased risk of hepatotoxicity associated with antiretroviral therapy (ARV). We carried out biochemical, immunological, virological and clinical analysis of hepatitis B and C positive HIV patients as well as some HIV positive individuals receiving antiretroviral therapy in Kumba Health District to evaluate the immune response to the ARV therapy and identified risk factors associated with the treatment outcomes. A total of 52 HIV patients, 36 HIV/HBV and 12 HIV/HCV patients were involved in this study. We performed CD4 counts, viral load test, analyzed ALAT/ASAT, albumin, bilirubin, and creatinine and measured the weights of HIV patients, HIV/HBV and HIV/HCV enrolled for not more than one year in Kumba Health District. The results were analyzed to evaluate the immune response and possible risk factors associated with the treatment outcomes. The mean increase in weight in participants of all groups over 12 months (17.12 kg) was greater than the mean increase in CD4 (8.92 cell/mm3). However, the mean decrease in viral loads over a 12 months was also very high (1035.17 copies/mL). There was a significant change in the mean values from baseline for all the three variables (p < 0.0001). HIV disease outcomes following HAART (high active antiretroviral therapy) do not appear to be adversely affected by HBV or HCV co-infection, except for slightly poorer CD4 count responses in HIV/HCV co-infected patients. Concerning the renal and liver functions, all the biomarkers witnessed a decrease in patients of all groups in response to HAART over time, with a more rapid decrease in mono-infected patients as compared with those co-infected with HBV but the case was contrary for those co-infected with HCV. Co-infection with HBV or HCV was relatively common among HIV infected participants in Kumba Health District. There were differences in response to HAART between the mono-infected compared with the co-infected, taking into consideration the weight, CD4 count, and viral load. In addition, there was also a variation in the different biomarkers of liver and renal function between mono-infected and co-infected patients.
Highlights
Viral hepatitis has emerged as an important public health problem globally
It further sought to identify associated risk factors linked to the treatment outcome among these human immunodeficiency virus (HIV)-1 infected patients placed on HAART, which would contribute toward the understanding of the burden of the viral hepatitis co-infections and at-risk populations in Cameroon
Co-infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) is relatively common among HIV-infected participants in Kumba Health District
Summary
Viral hepatitis has emerged as an important public health problem globally. It is characterized by high prevalence, a high burden in terms of morbidity and mortality, and suboptimal diagnosis and management approaches in developing countries [1,2]. Hepatitis B (HBV) and C (HCV) are two among the numerous forms of infections whose clinical degeneration, morbidity–mortality and poor immune responsiveness in people living with human immunodeficiency virus (HIV) are highly evident [3,4]. HBV and HCV account for 60% of cirrhosis, 80% of hepatocellular carcinoma and 1 million deaths each year and the burden of chronic hepatitis mostly affects resource-limited countries [6]
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